Analyzing Discharge Strategies during Acute Care

Elizabeth A. Crawford, Pratik J. Parikh, Nan Kong and Charuhas V. Thakar

Medical Decision Making, 2014, vol. 34, issue 2, 231-241

Abstract: Background. When to discharge acute care patients is a complex decision that depends on both patient- and system-level factors. Such a decision for one patient affects other patients and operations in a hospital. The key tradeoff that we analyzed was the effect of discharge timing on several emergency department (ED)-related measures and the number of readmissions. Methods . We developed a discrete-event simulation model of patient pathway through an acute care hospital that comprises an ED and several inpatient units. The effects of discharge timing on ED waiting and boarding times, ambulance diversions, leave without treatment, and readmissions were explicitly modeled. We then analyzed the impact of 1 static and 2 proactive discharge strategies on these system outcomes. Results . Our analysis indicated that although the 2 proactive discharge strategies significantly reduced ED waiting and boarding times, and several other measures, compared with the static strategy ( P

Keywords: acute care; ED crowding; inpatient discharge; discrete-event simulation (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:34:y:2014:i:2:p:231-241

DOI: 10.1177/0272989X13503500

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